16 May 23

Medicaid Healthcare Audit Lawyers

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Last Updated on: 3rd June 2023, 09:10 pm

Audits for Health Care Providers: Safeguard Your Reputation and Secure Your Livelihood

As a dedicated health care provider, the thought of facing an audit can be an incredibly daunting and anxiety-inducing experience. Audits are meticulously designed to detect fraudulent activities and erroneous Medicaid or Medicare claims, with the ultimate goal of recouping any excess payments made by the government. Unfortunately, audits can also arise due to trivial mistakes in intricate paperwork or misunderstandings of contract provisions, even in the absence of authentic fraudulence.

At Spodek Law Group, our highly skilled and knowledgeable attorneys specialize in handling an array of audits. We recognize that each audit is unique, yet we also understand that there is one unwavering truth – it is imperative to be well-prepared and have a strategic plan of action in place. Our ultimate objective is to vigorously aid you in defending against any accusations you face, ensuring the most triumphant outcome possible.

Medicaid Audits: Crucial Information You Need to Be Aware Of

Medicaid fraud is an egregious offense that drains taxpayers of millions of dollars annually. In response, the Medicaid Integrity Program (MIP) was established to seek out and prevent Medicaid fraud by identifying overpayments and inaccurate claims. The MIP is enforced by several Medicaid Integrity Contractors (MICs) who perform audits on providers’ claims submitted up to five years prior.

MICs are categorized into three distinct types based on their primary responsibilities: review MICs target providers requiring auditing; education MICs deliver training on avoiding improper payments; and audit MICs assume cases from review MICs after alerting providers with a notice of the audit request records.

Our accomplished attorneys at Spodek Law Group possess extensive experience with audits conducted by various MIC types as well as the appeals processes linked to them. We meticulously evaluate your case’s unique intricacies before devising a tailored, individualized approach that meets your specific demands.

Medicare Audits: Vital Details You Must Be Informed Of

Medicare audits focus on guaranteeing that health care providers receive reimbursement solely for services rendered while meeting medical necessity coverage conditions as mandated by Medicare guidelines. Inadvertent blunders such as those resulting from convoluted paperwork or misinterpretation of contractual provisions can inadvertently trigger an audit, even when there is no evidence of intentional fraud.

It is of utmost importance that an attorney is contacted without delay when confronted by a Medicare audit. Our astute attorneys at Spodek Law Group appreciate that many CMS contractors receive payment based on the amount of money they recoup, causing them to be less inclined to negotiate and strive to recover the maximum funds possible. We are equipped to support you at every stage of the audit, ranging from notification to appeal.

Why Hiring a Professional Medicaid Healthcare Audit Attorney is Essential

A conviction for Medicaid fraud can inflict devastating consequences, such as imprisonment, crippling fines, and suspension or even permanent revocation of your license to practice. This is a colossal loss you simply cannot afford. Consequently, it is crucial to secure the services of a highly experienced Medicaid healthcare audit lawyer immediately upon receipt of notification of an impending hearing.

At Spodek Law Group, we empathize that audits can be highly unpleasant and distressing experiences for providers. Our skilled attorneys are committed to guiding you through this arduous process by identifying discrepancies and other errors in the audit report while ensuring that you receive exemplary legal representation throughout the proceedings.


Confronting an audit can be a harrowing ordeal, but formulating a proactive plan of action is indispensable in safeguarding your reputation and preserving your livelihood as a health care provider. At Spodek Law Group, we boast an impressive track record of experience with audits conducted by various MIC types and related appeals processes.

Our dedicated attorneys work indefatigably on behalf of clients like you who confront allegations spanning from simple mistakes due to complex paperwork issues to criminal prosecution charges stemming from fraudulent practices within their billing systems – regardless of the type or severity! Connect with us today for more details on how we can help defend your interests during this tremendously challenging period!

Medicaid Healthcare Audit Lawyers

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